1. Field of the Invention
The present invention relates to a method of angiography of coronary arteries, vein bypasses, gastroepiploic arteries and internal thoracic arteries.
2. Description of the Prior Art
In accordance with the increasing cases of percutaneous angiography or coronary arterial bypass surgeries, cases of repeating coronary arterial and bypass angiography have increased. Also, in the western countries, for the purpose of cost saving of medical expenses, increasing numbers of coronary artery angiography cases have been performed in outpatient sites.
Conventionally, coronary artery angiography has employed two methods. The first method, termed the "Judkins" method, comprises the step of puncturing a paracentetic tube into the femoral artery, from which a catheter is inserted. The second method, termed the "Sones" method, comprises the step of incising the skin of the brachial region to expose the artery, to which a hole is formed to be inserted by a catheter.
Advantages and disadvantages of the prior art are as follows. In the Judkins method, performed only by puncture of a paracentetic tube into a blood vessel, compared to the Sones method performed by incision of the vessel, damage to skin and vessels is minimized. Also, insertion of a catheter from the paracentetic tube into the blood vessel minimizes damage to the blood vessel caused by entrance and exit of the catheter.
Since the process is perfomed without incision of cortex and blood vessel, no wound or adhesion of wound region remains. Therefore, even in angiography which requires frequent repetition of angiographic processes, it is advantageous to repeat such processes from the same region.
In the Judkins method, the catheter used is preformed to easily enter the coronary artery, and may be operated by a beginner with only relatively short-term training.
On the other hand, one disadvantage of the Judkins method is that the patient would feel ashamed because the catheter is inserted from the femoral region.
Since the paracentetic tube is punctured, its removal often causes bleeding, necessitating a long recovery period.
For angiography of the left and right coronary arteries and venous bypass, separate catheters are employed, respectively. Necessary replacement of the catheters is time consuming and increases the costs associated with performing angiography. Moreover, the Judkins method cannot be employed for cases of arterial obliteration, such as stenosis in the gastroepiploic artery or femoral artery.
Concerned with cost saving, most western countries are hesitant to perform the Judkins method even though there are increasing cases for performing coronary artery angiography in outpatient sites or mobile angiography in automobiles.
In the Sones method, the brachial region is incised to expose the artery, and a catheter is inserted in the opening. By using a brachium, the patient does not feel ashamed.
After an angiograph is performed, the opening is seamed. Since the incised region is in the brachium, recovery time required after angiography is reduced to one hour or less. Moveover, only one catheter is used for forming angiograph of both the right coronary artery and the venous bypass.
A disadvantage of the Sones method is that the patient necessarily must undergo surgery and suffers from the burden and the time necessary for the operation. Also, the incised cortex causes the vessel to be exposed leaving a wound and adhesion. As a result, the incision cannot be done at the same region, and repeated angiographic operations must be done in shifted positions, thereby the region to be incised is limited in repeated cases. In addition, the techniques of cutaneous incision or insertion of the catheter into the coronary artery or bypass are so difficult that they require a one to two year period of time to acquire the technique. Cost concerns in most western countries also cause performing the Sones method to be prohibitively expensive although there are increased cases for performing coronary artery angiography in outpatient sites.